NOTE: Where it is feasible, a syllabus (headnote) will be released,
as is being done in connection with this case, at the time the opinion
is issued. The syllabus constitutes no part of the opinion of the Court
but has been prepared by the Reporter of Decisions for the convenience
of the reader. See United States v. Detroit Timber & Lumber
Co.,200
U.S. 321, 337.

SUPREME COURT OF THE UNITED STATES

Syllabus

VACCO, ATTORNEY GENERAL OF
NEW YORK, et al. v. QUILL et al.

certiorari to the united states
court of appeals for the second circuit

No. 95-1858.
Argued January 8, 1997 -- Decided
June 26, 1997

In New York, as in most States, it is a crime to aid another to commit
or attempt suicide, but patients may refuse even lifesaving medical treatment.
Respondent New York physicians assert that, although it would be consistent
with the standards of their medical practices to prescribe lethal medication
for mentally competent, terminally ill patients who are suffering great
pain and desire a doctor's help in taking their own lives, they are deterred
from doing so by New York's assisted suicide ban. They, and three gravely
ill patients who have since died, sued the State's Attorney General, claiming
that the ban violates the Fourteenth
Amendment's Equal Protection Clause. The Federal District Court disagreed,
but the Second Circuit reversed, holding (1) that New York accords different
treatment to those competent, terminally ill persons who wish to hasten
their deaths by self administering prescribed drugs than it does to those
who wish to do so by directing the removal of life support systems, and
(2) that this supposed unequal treatment is not rationally related to any
legitimate state interests.

Held: New York's prohibition
on assisting suicide does not violate the Equal Protection Clause. Pp.
3-14.

(a) The Equal Protection Clause
embodies a general rule that States must treat like cases alike but may
treat unlike cases accordingly. E.g., Plyler v. Doe,457
U.S. 202, 216. The New York statutes outlawing assisted suicide neither
infringe fundamental rights nor involve suspect classifications, e.g.,
Washington v. Glucksberg, ante, at 14-24, and are therefore
entitled to a strong presumption of validity, Heller v. Doe,509
U.S. 312, 319. On their faces, neither the assisted suicide ban nor
the law permitting patients to refuse medical treatment treats anyone differently
from anyone else or draws any distinctions between persons. Everyone,
regardless of physical condition, is entitled, if competent, to refuse
unwanted lifesaving medical treatment; no one is permitted to assist
a suicide. Generally, laws that apply evenhandedly to all unquestionably
comply with equal protection. E.g., New York City Transit Authority
v. Beazer,440
U.S. 568, 587. This Court disagrees with the Second Circuit's submission
that ending or refusing lifesaving medical treatment "is nothing more nor
less than assisted suicide." The distinction between letting a patient
die and making that patient die is important, logical, rational, and well
established: It comports with fundamental legal principles of causation,
see, e.g.,People v. Kevorkian, 447 Mich. 436, 470-472,
527 N. W. 2d 714, 728, cert. denied, 514
U.S. 1083, and intent, see, e.g., United States v. Bailey,444
U.S. 394, 403-406; has been recognized, at least implicitly, by this
Court in Cruzan v. Director, Mo. Dept. of Health,497
U.S. 261, 278-280; id., at 287-288 (O'Connor, J., concurring);
and has been widely recognized and endorsed in the medical profession,
the state courts, and the overwhelming majority of state legislatures,
which, like New York's, have permitted the former while prohibiting the
latter. The Court therefore disagrees with respondents' claim that the
distinction is "arbitrary" and "irrational." The line between the two acts
may not always be clear, but certainty is not required, even were it possible.
Logic and contemporary practice support New York's judgment that the two
acts are different, and New York may therefore, consistent with the Constitution,
treat them differently. Pp. 3-13.

(b) New York's reasons for recognizing and acting on the distinction
between refusing treatment and assisting a suicide--including prohibiting
intentional killing and preserving life; preventing suicide; maintaining
physicians' role as their patients' healers; protecting vulnerable people
from indifference, prejudice, and psychological and financial pressure
to end their lives; and avoiding a possible slide towards euthanasia--are
valid and important public interests that easily satisfy the constitutional
requirement that a legislative classification bear a rational relation
to some legitimate end. See Glucksberg, ante. Pp. 13-14.

80 F. 3d 716,
reversed.

Rehnquist, C. J., delivered
the opinion of the Court, in which O'Connor, Scalia, Kennedy, and Thomas,
JJ., joined. O'Connor, J., filed a concurring opinion, in which Ginsburg
and Breyer, JJ., joined in part. Stevens, J., Souter, J., Ginsburg, J.,
and Breyer, J., filed opinions concurring in the judgment.